scholarly journals Complications of Stapled Haemorrhoidectomy for Primary Haemorrhoid – Our Experience in ShSMCH

2018 ◽  
Vol 9 (2) ◽  
pp. 78-82
Author(s):  
Krishna Pada Saha ◽  
Md Ibnul Hasan ◽  
Fayem Chowdhury ◽  
Abdullah Md Abu Ayub Ansary ◽  
Sadia Imdad ◽  
...  
Keyword(s):  
Urinary Retention ◽  
Clinical Examination ◽  
Rectal Bleeding ◽  
Anal Pain ◽  
Main Symptom ◽  
Mild Pain ◽  
Operative Complication ◽  
Presenting Symptoms ◽  
Stapled Haemorrhoidectomy ◽  
Flatus Incontinence

Objective: The aim of the study was to cheek the rate of significant complications amongst the patients undergoing Stapled haemorrhoidectomy. This study reflects our experience with Stapled haemorrhoidectomy in our Population.Methods: Two hundred and ninety patients with primary hemorrhoid of different degree underwent staple Hemorrhoidectomy in ShSMCH since January 2011 to December 2016. All patients were evaluated by history, clinical examination and proctosigmoidoscopy. They were followed up post operatively at 1, 3, 6, 12, 15, 18 Month.Result : Regarding presenting symptoms (pain less) per rectal bleeding was the main symptom (89%). Bulk of the pt were 3rd degree(50.16%). Regarding post operative complication – Urgency of defecation was most frequent (19%). Others were Urinary retention (4.5%), anal pain (4.01%), reactionary hemorrhage (4.01%). Regarding late post operative complication most frequent was mild pain (3.34%); others were – flatus incontinence, stenosis, recurrent haemorrhoid, fissure.Conclusion : Stapled haemorrhaidectomy is widely used, quick, safe and effective method of treating all degree of primary hemorrhoid with some complications. Therefore surgeon should be well aware of the type and post operative complicationsJ Shaheed Suhrawardy Med Coll, December 2017, Vol.9(2); 78-82

641 CLINICAL SYMPTOM PATTERNS IN PATIENTS WITH REFLUX ASPIRATION

2021 ◽  
Vol 34 (Supplement_1) ◽  
Author(s):  
Oleksandr Khoma ◽  
Jinsoo Park ◽  
Felix Lee ◽  
Hans Van der Wall ◽  
Gregory L Falk
Keyword(s):  
Large Volume ◽  
Symptom Clusters ◽  
Inclusion Criteria ◽  
Oesophageal Motility ◽  
Main Symptom ◽  
Presenting Symptoms ◽  
Throat Clearing ◽  
Specialist Centre ◽  
Symptom Patterns ◽  
Reported Data

Abstract   Multiple papers have discussed pulmonary manifestation of gastro-oesophageal reflux disease (GORD), however little primary reported data exists on presenting symptoms of patients in whom reflux aspiration is confirmed. The aim of this study is to report symptoms and presenting patterns of a large group of patients with confirmed reflux aspiration. Methods Data was extracted from a prospectively populated database of patients referred to a tertiary specialist centre with severe, refractory, or atypical reflux. Patients with reflux aspiration on scintigraphy were included in this study. Separate group included patients with evidence of proximal reflux to the level of pharynx when supine and/or upright. Results Inclusion criteria were met by 243 patients (33% males; mean age 59). Most common symptoms amongst patients with aspiration were regurgitation (72%), cough (67%), heartburn (66%), throat clearing (65%), and dysphonia (53%). The most common two-symptom combinations were heartburn/regurgitation, cough/throat clearing, regurgitation/throat clearing, cough/regurgitation and dysphonia/throat clearing. The most common three-symptom combinations were cough/heartburn/regurgitation, cough/regurgitation/throat clearing and dysphonia/regurgitation/throat clearing. Clusters analysis demonstrated two main symptom clusters one suggestive of proximal large volume reflux symptoms (regurgitation, heartburn) and the other with IBS type symptoms (bloat, dysphagia, constipation). Conclusion Combination of typical symptoms of GORD and a respiratory or upper aero-digestive complaint should prompt consideration of reflux aspiration. Cluster analysis of symptoms in this group supports previously postulated hypothesis of reflux aspiration pathogenesis by either large volume proximal reflux or by ineffective oesophageal motility.

scholarly journals Reversible urinary retention as the main symptom in the first manifestation of a syringomyelia.

1996 ◽  
Vol 61 (4) ◽  
pp. 407-408 ◽  
Author(s):  
G Amoiridis ◽  
S Meves ◽  
L Schols ◽  
H Przuntek
Keyword(s):  
Urinary Retention ◽  
Main Symptom

Residual staples as a possible cause of recurrent rectal bleeding after stapled haemorrhoidectomy

2003 ◽  
Vol 5 (2) ◽  
pp. 196-196 ◽  
Author(s):  
H. M. Quah ◽  
H. I. A. Hadi ◽  
D. J. Hay ◽  
A. Maw
Keyword(s):  
Rectal Bleeding ◽  
Stapled Haemorrhoidectomy ◽  
Possible Cause

scholarly journals Urinary Retention After Haemorrhoidectomy: Impact of Stapled Haemorrhoidectomy

2006 ◽  
Vol 29 (4) ◽  
pp. 233-237 ◽  
Author(s):  
Barbara Chik ◽  
Wai Lun Law ◽  
Hok Kwok Choi
Keyword(s):  
Urinary Retention ◽  
Stapled Haemorrhoidectomy

scholarly journals Clinical profile of children with tuberculosis from a semi urban referral centre in South India: a prospective observational study

2019 ◽  
Vol 6 (4) ◽  
pp. 1450
Author(s):  
Anuradha G. ◽  
Muraleetharan G.
Keyword(s):  
Clinical Examination ◽  
Complete Blood Count ◽  
Childhood Tuberculosis ◽  
Diagnostic Methods ◽  
Clinical Profile ◽  
Mantoux Test ◽  
Presenting Symptoms ◽  
Bacteriological Diagnosis ◽  
Laboratory Investigations ◽  
Extra Pulmonary

Background: Global TB report 2018 reports that in India, an estimated 2.2 lakh children become ill with tuberculosis (TB) each year. In spite of new rapid diagnostic methods, lack of gold standard test for confirming childhood tuberculosis remains an obstacle for the effective reporting of childhood TB and hence these cases often remain under diagnosed. The main objective was to study the clinical profile of childhood tuberculosis with relevant laboratory investigations aiding in early diagnosis.Methods: A prospective observational hospital-based study was conducted in IRT-Perundurai medical college hospital from April 2016 to March 2018. Children less than 18 years of age with tuberculosis were included in the study. Demographic details, presenting symptoms, family history of TB contact, nutritional status and clinical examination findings were documented. Complete blood count, ESR, Mantoux test, chest X-ray and sputum analyses for AFB were done for all patients.Results: Out of the total 124 children studied, the most common age of presentation of tuberculosis was >10 years of age (n=58, (46.8%)). There was a female preponderance (n=71 (57.25%)). Pulmonary tuberculosis (n= 87, (70.16%)) was the most common form followed by extra pulmonary (n=32, (25.80%)) and disseminated type (n=5, (4%)).  Lymph node TB was the most common manifestation (n=20, 62.50%) among extra pulmonary form. Cough (n=75, 60.5%) with sputum (n=55,44.4%) were the predominant symptoms noted followed by fever (n=53, 42.7%). Bacteriological diagnosis was possible in 19.5% (n=17) patients only.Conclusions: This study reinforces that the diagnosis of childhood tuberculosis is based on the constellation of symptom evaluation, contact history, clinical examination, with relevant laboratory investigations.

scholarly journals Different clinical symptom patterns in patients with reflux micro-micro-aspiration

2021 ◽  
pp. 00508-2021
Author(s):  
Oleksandr Khoma ◽  
Jin-soo Park ◽  
Felix Michael Lee ◽  
Hans Van der Wall ◽  
Gregory L Falk
Keyword(s):  
The Other ◽  
Inclusion Criteria ◽  
Voice Change ◽  
Main Symptom ◽  
Presenting Symptoms ◽  
Throat Clearing ◽  
Specialist Centre ◽  
Inflammatory Bowel ◽  
Symptom Patterns ◽  
Reported Data

BackgroundPulmonary manifestation of gastro-oesophageal reflux disease (GORD) is a well-recognised entity, however little primary reported data exists on presenting symptoms of patients in whom reflux micro-aspiration is confirmed. The aim of this study is to report symptoms and presenting patterns of a large group of patients with confirmed reflux micro-aspiration.Patients and methodsData was extracted from a prospectively populated database of patients referred to a tertiary specialist centre with severe, refractory, or atypical reflux. Patients with reflux micro-aspiration on scintigraphy were included in this study. Separate group included patients with evidence of proximal reflux to the level of pharynx when supine and/or upright.ResultsInclusion criteria were met by 243 patients with confirmed reflux micro-aspiration (33% males; mean age 59). Most common symptoms amongst patients with micro-aspiration were regurgitation (72%), cough (67%), heartburn (66%), throat clearing (65%), and dysphonia (53%). The most common two-symptom combinations were heartburn/regurgitation, cough/throat clearing, regurgitation/throat clearing, cough/regurgitation and dysphonia/throat clearing. The most common three-symptom combinations were cough/heartburn/regurgitation, cough/regurgitation/throat clearing and dysphonia/regurgitation/throat clearing. Cluster analysis demonstrated two main symptom groupings, one suggestive of proximal volume reflux symptoms and the other with motility/inflammatory bowel syndrome (IBS)-like symptoms (bloat, constipation).ConclusionCombination of typical symptoms of GORD such as heartburn or regurgitation and a respiratory or upper aero-digestive complaint such as cough, throat clearing, or voice change should prompt consideration of reflux micro-aspiration.

scholarly journals The diagnostic value of squirting rectal bleeding: The first description of such bleeding pattern

2021 ◽  
Vol 25 (2) ◽  
pp. 520-525
Author(s):  
Izzat Muttosh
Keyword(s):  
Clinical Examination ◽  
Clinical Evaluation ◽  
Rectal Bleeding ◽  
Diagnostic Value ◽  
Active Bleeding ◽  
Common Symptom ◽  
Bleeding Pattern ◽  
Bleeding Hemorrhoids

Background and objective: Rectal bleeding is a common symptom that has many patterns, but none of them are accurately diagnostic. One newly noticed pattern can be diagnostic, namely, the squirting pattern, for which this study was conducted. Methods: The study was conducted between Jan 2013 and Jun 2018, including 132 patients who presented with a squirting pattern of rectal bleeding, which is thought to be due to hemorrhoids. All these patients underwent clinical evaluation and anoscopy, and the majority (n=94) underwent colonoscopy. Results: At the time of clinical examination, 23 patients showed actively bleeding hemorrhoids. Fifteen patients were not convinced to undergo colonoscopy. The rest (n=94) who had no visible active bleeding at the time of examination underwent a colonoscopy to exclude other possible rectal or colonic pathology. All the 94 colonoscopies were negative for other bleeding sources. Two patients showed single benign non bleeding polyps, which were excised and biopsied. Conclusion: This study highlights a pattern of rectal bleeding that is not described before and proved it is a reliable diagnostic pattern for hemorrhoids. It also showed that colonoscopy is not needed in patients below 40 years complaining of squirting rectal bleeding unless indicated for some other reason. This decision is to be made very carefully. Keywords: Squirting rectal bleeding; Hemorrhoids; Colonoscopy.

scholarly journals Malignant Melanoma of the Rectum

2014 ◽  
Vol 4 ◽  
pp. 4 ◽  
Author(s):  
Supreethi Kohli ◽  
Seema Narang ◽  
Anu Singhal ◽  
Vinod Kumar ◽  
Omkar Kaur ◽  
...  
Keyword(s):  
Malignant Melanoma ◽  
Rare Disease ◽  
Rectal Bleeding ◽  
Complete Resection ◽  
Anal Pain ◽  
Pathological Features ◽  
Malignant Melanomas ◽  
Timely Diagnosis ◽  
Anal Melanoma ◽  
Sixth Decade

Malignant melanoma of the rectum is an extremely rare disease. It typically presents in the fifth or sixth decade of life with nonspecific complaints such as rectal bleeding or anal pain. A timely diagnosis of anal melanoma is made even more difficult by the fact that most of the lesions lack obvious pigmentation and are even histologically amelanotic. Prognosis is very poor. Anorectal malignant melanomas spread along submucosal planes and are often beyond complete resection at the time of diagnosis. We present the radiological and pathological features seen in a 43-year-old woman diagnosed with melanoma of the rectum.

scholarly journals Safe investigation of isolated change in bowel habit with a flexible sigmoidoscopy? A systematic review and meta-analysis

2019 ◽  
Vol 101 (6) ◽  
pp. 379-386
Author(s):  
PJJ Herrod ◽  
H Boyd-Carson ◽  
B Doleman ◽  
JEM Blackwell ◽  
EJO Hardy ◽  
...  
Keyword(s):  
Systematic Review ◽  
Rectal Bleeding ◽  
Flexible Sigmoidoscopy ◽  
Public Awareness ◽  
Meta Analysis ◽  
Bowel Cancer ◽  
Bowel Habit ◽  
Presenting Symptoms ◽  
Awareness Campaigns ◽  
Language Restriction

IntroductionPublic awareness campaigns have led to increasing referrals of patients to colorectal surgery for possible cancer. Change in bowel habit, is traditionally described as a symptom of a left sided bowel cancer. If this is the case in practice, it raises the potentially attractive option of investigating such patients with flexible sigmoidoscopy only. This study sought to systematically review the literature describing tumour location of patients with bowel cancer presenting with left-sided symptoms to establish the safety of potential investigation of these patients with flexible sigmoidoscopy alone.MethodsA systematic review of studies reporting both the presenting symptoms of patients with bowel cancer and the location of their cancer in the bowel was prospectively registered (CRD42017072492). MEDLINE, EMBASE and CENTRAL were searched with no date or language restriction.ResultsSeven studies were included. Isolated change in bowel habit (with or without rectal bleeding) was a presenting symptom of 73% (95% CI 41–96%, I2 = 99%) of left-sided cancers but also in 13% (95% CI 2–30%, I2 = 96%) of right-sided cancers. In all patients with cancer who presented with isolated change in bowel habit (with or without rectal bleeding), the cancer was right sided in 8% (95% CI 4–12%, I2 = 69%).ConclusionsThere is a higher than expected risk that if a cancer is diagnosed in a patient presenting with either an isolated change in bowel habit or a combination of change in bowel habit with rectal bleeding, the cancer may be right sided.

scholarly journals Comparison of Accuracy in Expert Clinical Examination versus Magnetic Resonance Imaging and Arthroscopic Exam in Diagnosis of Meniscal Tear

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Seyed Ali Hashemi ◽  
Mohammad Reza Ranjbar ◽  
Mohammad Tahami ◽  
Reza Shahriarirad ◽  
Amirhossein Erfani
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Clinical Examination ◽  
False Positive ◽  
Statistical Significance ◽  
False Negative ◽  
Test Results ◽  
Meniscal Tears ◽  
Resonance Imaging ◽  
Presenting Symptoms

Background. Many clinical tests and diagnostic studies have been developed to increase the clinician’s ability to accurately diagnose disorders of the knee. Torn menisci or ligamentous structures within the knee cause significant pain and disability and thus require expeditious management. This study was conducted to evaluate the accuracy of clinical examination in comparison with MRI examination and with the help of arthroscopic examination as the gold standard in the diagnosis of meniscal tears. Method. All of the arthroscopic surgery candidates, presenting symptoms of meniscal or cruciate ligament lesions, referring to Namazi and Chamran hospitals, Shiraz, Iran, were included in this study. Clinical examination (including McMurray test, Apley test, and 20 Thessaly test) was performed before the arthroscopy, and the results were recorded in special forms. Magnetic resonance imaging (MRI) results were also added. Then, arthroscopy was performed, declaring the definite diagnosis, and the results were compared to the results obtained from both tests and MRI. Statistical analysis was performed using SPSS software. Results. 86 patients with a mean age of 27 years old, including 63 (73%) male and 23 (27%) female, were studied. 57 (66%), 19 (22%), and 10 (12%) injuries were caused by sports, twisting, or trauma, respectively. Arthroscopic results showed 32 meniscal tears, of which 28 (87%) and 4 (13%) were in medial and lateral menisci, respectively, including 10 bucket handle, 17 longitudinal, and 5 of other types (transverse, oblique, radial) of injuries. Comparing MRI results to arthroscopic results, we had 2 false-positive and 2 false-negative cases. 62 cases of McMurray test results were accurate; 15 and 9 cases were reported false positive and false negative, respectively. 60 cases of Apley test results were accurate; 16 and 10 cases were reported false positive and false negative, respectively. 78 cases of Thessaly test results were accurate; 5 and 3 cases were reported false positive and false negative, respectively. Comparing Thessaly test results to McMurray and Apley showed statistical significance (P<0.05). Comparing Thessaly test results to MRI showed no statistical significance (P=0.151), while comparing McMurray and Apley test results to MRI showed statistical significance (P<0.01). Conclusion. Clinical examination, performed by an experienced examiner, can have equal or even more diagnostic accuracy compared to MRI to evaluate meniscal lesions. In this study, the Thessaly test has been approved as a reliable clinical test in the diagnosis of meniscal tears.

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